Vascularization in the liver transplant: normal findings and principal complications

Congress:

ECR 2020

Poster Number:

C-06509

Type:

Educational Exhibit

Keywords:

Ultrasound-Colour Doppler, MR, CT, Diagnostic procedure, Transplantation, Grafts, Abdominal Viscera, Liver, Abdomen

Authors:

C. González-Carrero Sixto¹, S. Sánchez Bernal¹, J. Crespo del Pozo², J. Azcona Saenz¹, D. HERRÁN DE LA GALA¹, F. J. GONZALEZ¹, A. Pérez Del Barrio ¹, T. Cobo Ruíz¹, D. Castanedo Vázquez¹; ¹Santander/ES, ²Selaya, Cantabria, España/ES

DOI:

10.26044/ecr2020/C-06509

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-06509

Fig. 2: Normal hepatic artery Doppler.

Fig. 3: Normal portal vein Doppler.

Fig. 4: Normal hepatic veins Doppler.

Fig. 5: Hepatic artery THROMBOSIS. The most common vascular complication after liver...

Learning objectives

Review the surgical techniques used in liver transplantation for vascular anastomosis. Describe the normal findings immediately after the procedure. Expose the most frequent acute postoperative vascular complications.

Background

Liver transplant is the treatment of choice for end stage liver disease. Since it was first performed in 1963, morbidity and mortality have significantly been reduced thanks to advances in surgical techniques, immunosuppressive therapy and multidisciplinary team approach. However, this procedure remains complex and vascular complications are one of the main causes of graft failure. Radiologists play a key role in the diagnose and follow-up of post-transplant complications. Their clinical manifestations are usually non-specific, so imaging is crucial in their prompt detection. Therefore, radiologists must...

Findings and procedure details

Ultrasonography (US) with Doppler studies should be performed in the first 24-48 hours after the procedure and before discharge, for gross evaluation of the liver parenchyma, biliary tree and graft vasculature. NORMAL RADIOLOGIC FINDINGS Hepatic artery Hepatopetal flow. Sharp systolic peak

Conclusion

Survival after orthotopic liver transplant has significantly improved mostly tanks to a multidisciplinary approach. Imaging tests are essential in the management of patients after liver transplantation. Radiologists must be able to recognize normal and pathological findings after a liver transplant. Early detection and treatment of postoperative complications is necessary for achieving graft and patient survival.

Personal information and conflict of interest

C. González-Carrero Sixto; Santander/ES - nothing to disclose S. Sánchez Bernal; Santander/ES - nothing to disclose J. Crespo Del Pozo; Selaya, Cantabria, ESPAÑA/ES - nothing to disclose J. Azcona Saenz; Santander/ES - nothing to disclose D. Herrán de la Gala; Santander/ES - nothing to disclose T. Cobo Ruíz; Santander/ES - nothing to disclose F. J. Gonzalez; Santander/ES - nothing to disclose D. Castanedo Vázquez; Santander/ES - nothing to disclose A. Pérez Del Barrio; Santander/ES - nothing to disclose

References

Crossin JD, Muradaly D, Wilson SR. US on liver transplant: normal and abnormal. RadioGrapics 2003; 23:1093-1114. Baheti A.D., Sanyal R., Heller M.T., Bhargava P. Surgical techniques and imaging complications of liver transplant. Radiol. Clin. N. Am. 2016; 54: 199-215. Ajay K. Singh, Arun C. Nachiappan, Hetal A. Verma, Raul N. Uppot, Michael A. Blake, Sanjay Saini, Giles W. Boland. Postoperative Imaging in Liver Transplantation: What Radiologists Should Know. Akshay D. Baheti, MD, Rupan Sanyal, MD, Matthew T. Heller, MD, Puneet Bhargava, MD. Su rgical Techniques...